7 tips for writing fiction about mental health

Blah blah it’s PC gorn mad, you can’t even write about assaulting women as a crap plot device anymore and characters of colour have to be actual fully realised, culturally-appropriate people and now mad people have to be written properly too? HOW VERY DARE THEY?! PASS ME MY DAILY MAIL!

Look, we all know that stories are important and that representation is important and people who might not immediately seem the same as you have their own rich internal lives and external cultures which are important and while fiction necessarily needs to be free to explore and collapse and expand the rules of society it also needs to not be a dick.

Here comes the science: one in four people experience mental health issues at some point during their life. That gives fiction writers a rich and important seam of psychological fodder to (sensitively) mine, but, as with any other topic you might write about, it needs careful research and thought to make it relatable, believable and responsible.

“But does fiction really need to be ‘responsible’?”

Well duh. Responsible doesn’t have to mean boring or safe. Actually it can mean quite the opposite. But that’s a whoolllle other blog post. ANYWAY, LET’S CRACK ON.

And so we present to you, the Writers’ HQ Guide To Writing About Mental Illness Without Being A Dick. Grease your loins, we’re going in…

1. Yeah, no

Gif of Brad Pit in 12 Monkeys saying "wackos everywhere, a plague of madness"

 Wibble wibble I’m so c-r-a-z-y, me. Fuck off, Brad and all those generic, one-dimensional Hollywood ‘representations’ of mental health patients who are afforded no personality beyond their condition. If you’re going to write a character with mental health issues, start with THE PERSON and make them a fully-rounded individual before considering how their symptoms might affect them.

2. Bad guy =/= crazy

There’s not necessarily anything wrong with having a bad guy with mental health problems, but making them bad because of their mental health problems? Nah bro. What is that perpetuating? Is it even real? Who is buying into that? (Spoiler: no one). How many depressives would it really take to plot the downfall of the global elite? I mean, a handful could probably manage it with careful planning but only on a good spoon day. The big question is WHY?! Antagonists need motivation, too – in fact, antagonists need to believe they are the protagonist of their story, and therefore need to be able to justify their actions within a comprehensible framework. If they also happen to have anxiety which makes them a bit of an awkward conversationalist, that’s simply an added character nuance. This isn’t about mental health, this is about quality writing. “I’m in a really shitty place right now” is not good enough motivation for anyone to do anything – in fact, they’d most likely go back to bed rather than try to take over the world.

3. Love is not a magical cure

Sure, we all need sweet, sweet love, but mental health problems don’t just magically go away when the protagonist succeeds and gets it oh-diggedy-on with their love interest. Living with mental health issues can be fucking hard. Sometimes it’s a lifelong struggle. Of course having supportive friends and family is important, but it’s not a cure-all. The bigger picture is about coping and living with it, not about magicking it away. Therapy is also an option.

4. Yeah, no

Image by Tatsuya Ishida at Sinfest

Enough of the Manic Pixie Dream Girl. Do not romanticise mental health problems fgs. You cannot ‘save’ someone with mental health problems by flicking your hair seductively and playing them some Sufjan Stevens. Each person has their own journey. Your protagonist doesn’t exist to be someone else’s hero. Your love-interest isn’t there just to be saved. Use your nuance gland. It helps.

5. Who’s that trip trope-ing across my bridge

Mental health conditions vary enormously from person to person. You might never know one person has depression, while another with chronic anxiety can’t leave their house. One person might manage their panic disorder with meditation while another self-medicates with alcohol (not something we recommend btw).

Check up on symptoms and how they present and think about how you might represent those in your fiction in clever ways. Have a look at the usual load of stereotypes about mental health problems, check you haven’t fallen into those traps and see if there’s a way you can cunningly counter them (while obv watching your authorial voice). Avoid the usual tropes about those wacky people who ‘just need to get on their meds and man-up’. Arg.

A clue for how to proceed: go speak to some people with mental health issues! They’re not short on the ground and those living with the day-to-day realities of mental health problems really are the best people to explain what it’s like to live with a mental health problem, and the people who most want to see you get it right. Can’t find anyone? Ask on Twitter or volunteer at a local charity. There’s a whole loada people out there willing to talk to you.

6. Name the problem

Generic Oddity is not an official diagnosis, neither is Ambiguous Disorder. Avoid having your character’s mental illness or neurodiversity manifest as crap-and-slightly-offensive characterisation or flimsy-plot-device by actually naming the problem. So your character is autistic or bipolar or ADHD? Cool. Say it out loud instead of vaguely coding them as ‘a bit of a weirdo’ and then go aaaall the way back to number 1 on this list and figure out who they are AS A PERSON before you even start to consider how their particular challenges and attributes might affect their story.

7. General miscellany

Unless you’re in the 1950s or prior, psych wards are not like in the films, and they are definitely not called mental asylums. Antidepressants are not an instant cure and nor do they turn people into useless zombies. Most people with mental health issues aren’t violent and if they are it isn’t always specifically because of their mental health problems.

Some good eggs of mental health writing

Need more inspiration? Try these for some great examples of writing about mental health:

  • Faces in the Water by Janet Frame
  • The Bell Jar by Sylvia Plath
  • Darkness Visible by William Styron
  • I Never Promised You A Rose Garden by Joanne Greenberg
  • The Hours by Michael Cunningham
  • Prozac Nation by Elizabeth Wurtzel
  • An Unquiet Mind by Kay Redfield Jamison
  • The Man Who Mistook His Wife For A Hat by Oliver Sacks
  • The Quiet Room by Lori Schiller and Amanda Bennet

And that’s just a start. There are a load more on this list, and this one, and oh lookie here

With such a wealth of information out there, there’s really no excuse for shitty mental health representation. So go forth and spread the word, do us proud, and write some amazing, complicated, real characters.

With thanks to Time to Change and Mind for their guides to writing and reporting on mental health.

Sarah Lewis

Sarah Lewis

Sarah is one half of Writers' HQ. She writes a lot of short bios about herself.
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